Next in Line: Building a Succession Pipeline for Advanced Practitioners in Oncology

Advanced practitioners (APs; nurse practitioners, physician associates, clinical nurse specialists, advanced degree nurses, and pharmacists) are vital in providing high-quality, specialized patient care, particularly in oncology. Despite the tremendous value that APs bring to health-care systems, an aging workforce, turnover, and burnout underscore the urgent need for structured leadership succession planning. Nursing and pharmacy data reveal that 30% to 50% of leaders plan to retire within 5 years, yet few organizations have formal processes to replace them. Without proactive planning, there is a risk that clinical expertise, leadership continuity, and program stability will be lost. Advanced practitioner-specific succession planning is especially critical due to the unique clinical and operational roles that APs play in health-care systems outside of patient care, such as in quality improvement and clinical program development. A comprehensive framework includes aligning succession planning with organizational strategy, defining leadership roles, assessing the risk of future vacancies, and securing executive support, as well as talent identification focusing on diversity and inclusion. Clear career pathways and structured leadership training further strengthen the path from staffing to leadership. Barriers to succession planning include organizational resistance to career development pathways, limitations in funding, unconscious bias, and fear of talent loss. Addressing these challenges demands executive sponsorship, transparent hiring and promotion processes, and a culture that normalizes leadership development. In oncology-where APs are central to care coordination-the absence of succession planning threatens care continuity and program development. Institutions must adopt structured, inclusive succession planning models to maintain patient-centered care and ensure a resilient future AP leadership workforce.